2006, Number 01
<< Back Next >>
Ginecol Obstet Mex 2006; 74 (01)
Endometrial receptivity: numerical classification to successful prognosis in assisted reproduction programs
Hernández AS, Santos HR, Galache VP, Flores TH, González S
Language: Spanish
References: 20
Page: 13-19
PDF size: 0. Kb.
ABSTRACT
Background: Currently, the most precise way of predicting uterine receptivity is the histopathological study through endometrial biopsy. Endometrial morphology and thickness are the factors most strongly associated with better pregnancy rates.
Objective: To evaluate the prediction value of a numerical grade to predict pregnancy in patients exposed to assisted reproductive techniques.
Patients and methods: 22 cycles of in vitro fertilization were made at the Instituto para el Estudio de la Concepción Humana in Monterrey, Nuevo León, from June 2003 to January 2004. We evaluated and categorized: endometrial thickness and morphology, vascularity, miometrial ecogenicity, and uterine artery blood flow (including pulsatility and resistance indexes, presence of protodyastolic nicks, and telediastolic flow). The final numerical grade result from the sum of the individual values obtained for each factor.
Results: We included 22 cycles of 20 patients. The general pregnancy and implantation rate was of 40 (8/20) and 26% (17/65) per cycle, respectively. The most common diagnosis was tube occlusion (28%), followed by masculine sex (24%), endometriosis (14%), anovulation (14%), and inexplicable (14%). There were no statistical differences among the pregnant and non-pregnant groups regarding: age, hormonal profile (FSH and estradiol, basal and at the tenth day), total of recombinant FSH unities, follicles ≥ 14 mm the day of applying human chorionic gonadotropin, aspired eggs, fertilization index, and transferred embryos.
Conclusions: Endometrial maturity is essential for implantation during an assisted reproductive procedure.
REFERENCES
Fanchin R. Assessing uterine receptivity in 2001: ultrasonographic glances at the new millenium. Ann NY Acad Sci 2001;943:185-202.
Kovacs P, Matyas S, Boda K, Kaali SG. The effect of endometrial thickness on IVF/ICSI outcome. Hum Reprod 2003;18(11):2337-41.
Noyes N, Liu H, Sultan K, Schattman G, Rosenwaks Z. Endometrial thickness appears to be a significant factor in embryo implantation in in-vitro fertilization. Hum Reprod 1995;10:919-22.
Santos R, et al. Grosor endometrial: ¿predicción de embarazo en reproducción asistida? Ginecol Obstet Mex 2003;71(Suppl 1):42.
Gonen Y, Casper R. Prediction of implantation by the sonographic appearance of the endometrium during controlled ovarian stimulation for in vitro fertilization (IVF). J In Vitro Fert Embryo Transf 1990;7(3):146-52.
Dietterich C, Check J, Choe J, Nazari A, Lurie O. Increased endometrial thickness on the day of human chorionic gonadotropin injection does not adversely affect pregnancy or implantation rates following in vitro fertilization-embryo transfer. Fertil Steril 2002;77(4):781-6.
Raine-Fenning N, Campbell B, Kendall N, Clewes J, Johnson I. Quantifying the changes in endometrial vascularity throughout the normal menstrual cycle with three-dimensional power Doppler angiography. Hum Reprod 2004;19(2):330-8.
Chien L, Au H, Chen P, Xiao J, Tzeng C. Assessment of uterine receptivity by the endometrial-subendometrial blood flow distribution pattern in women undergoing in vitro fertilization-embryo transfer. Fertil Steril 2002;78(2):245-51.
Zaidi J, Campbell S, Pittrof R, Tan S. Endometrial thickness, morphology, vascular penetration and velocimetry in predicting implantation in an in vitro fertilization program. Ultrasound Obstet Gynecol 1995;6(3):191-8.
Steer C, Tan S, Dillon D, Mason B, Campbell S. Vaginal color Doppler assessment of uterine artery impedance correlates with immunohistochemical markers of endometrial receptivity required for the implantation of an embryo. Fertil Steril 1995;63(1):101-8.
Schild R, Knobloch C, Dorn C, Fimilimetrosers R, van der Ven H, Hansmann M. Endometrial receptivity in an in vitro fertilization program as assessed by spiral artery blood flow, endometrial thickness, endometrial volume, and uterine artery blood flow. Fertil Steril 2001;75(2):361-6.
Pellicer A, Simón C, Acién P. Miomas y esterilidad/infertilidad. Cuadernos de Medicina Reproductiva 1999;5:75.
Hung Yu Ng E, Chung Ho P. Doppler ultrasound examination of uterine arteries on the day of oocyte retrieval in patients with uterine fibroids undergoing IVF. Hum Reprod 2002;17:765-70.
Check J, Choe J, Lee G, Dietterich C. The effect on IVF outcome of small intramural fibroids not compressing the uterine cavity as determined by a prospective matched control study. Hum Reprod 2002;17(5):1244-8.
Eldar-Geva T, Meagher S, Healy D, MacLachlan V, Breheny S, Wood C. Effect of intramural, subserosal, and submucosal uterine fibroids on the outcome of assisted reproductive technology treatment. Fertil Steril 1998;70(4):687-91.
Cacciatore B, Simberg N, Fusaro P, Tintinen A. Transvaginal Doppler study of uterine artery blood flow in in-vitro fertilization-embryo transfer cycles. Fertil Steril 1996;66(1):130-4.
Applebaum M. The uterine biophysical profile. Ultrasound Obstet Gynecol 1995;5(1):67-68.
Serafini P, Nelson J, Batzofin J, Olive D. Preovulatory sonographic uterine receptivity index (SURI): usefulness as an indicator of pregnancy in women undergoing assisted reproductive treatments. J Ultrasound Med 1995;14(10):751-5.
Baruffi R, Contart P, Mauri A, Petersen C, Felipe V, Garbellini E, et al. A uterine sonographic score system as a method for the prognosis of embryo implantation. J Assist Reprod Genet 2002;19(3):99-102.
Salle B, Bied-Damon V, Benchaib M, Desperes S, Gaucherand P, Rudigoz R. Preliminary report of an ultrasonography and colour Doppler uterine store to predict uterine receptivity in an